The Men of Honor Youth Mentorship Program Inc.

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

THE MEN OF HONOR YOUTH MENTORSHIP PROGRAM INC.

Practice address

28 Dalton PL FL 2N
Springfield, MA 01109-1611

Phone

(413) 885-0416

NPI assigned

Feb 8, 2021

Last updated

Feb 8, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Charles Elmore Smith, MASTER LEVEL CLINICINPI 1649630633

Title

President

Phone

(413) 885-0416

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charles Elmore Smith

  • Mental Health Counselor
  • Springfield, MA
  • NPI 1649630633
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612742400000",
    "number": "1053903336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 DALTON PL FL 2N",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011091611",
            "telephone_number": "413-885-0416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 DALTON PL FL 2N",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011091611",
            "telephone_number": "413-885-0416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MEN OF HONOR YOUTH MENTORSHIP PROGRAM INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-08",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "ELMORE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "413-885-0416",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MASTER LEVEL CLINICI"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Management Agency in Springfield, MA
• Providers in Springfield, MA by specialty
• Case Management Agency in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.